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Apparatus and methods for mapping and ablation in electrophysiology procedures

Info

Publication number
WO2001082814B1
WO2001082814B1 PCT/US2001/013840 US0113840W WO2001082814B1 WO 2001082814 B1 WO2001082814 B1 WO 2001082814B1 US 0113840 W US0113840 W US 0113840W WO 2001082814 B1 WO2001082814 B1 WO 2001082814B1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
device
medical
conductive
braided
member
Prior art date
Application number
PCT/US2001/013840
Other languages
French (fr)
Other versions
WO2001082814A2 (en )
WO2001082814A3 (en )
Inventor
Russell F Collins
Gary S Falwell
Eric A Bene
Steven J Burns
Denyse M Collins
Charles A Gibson
Ding Sheng He
Paul E Leclair
Donald F Patterson
Stephen W Sagon
Pierre Jais
Original Assignee
Bard Inc C R
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00059Material properties
    • A61B2018/00071Electrical conductivity
    • A61B2018/00083Electrical conductivity low, i.e. electrically insulating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/0016Energy applicators arranged in a two- or three dimensional array
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00184Moving parts
    • A61B2018/00196Moving parts reciprocating lengthwise
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/00267Expandable means emitting energy, e.g. by elements carried thereon having a basket shaped structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00797Temperature measured by multiple temperature sensors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00821Temperature measured by a thermocouple
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091Handpieces of the surgical instrument or device
    • A61B2018/00916Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • A61B2018/0094Types of switches or controllers
    • A61B2018/00946Types of switches or controllers slidable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1497Electrodes covering only part of the probe circumference

Abstract

An electrophysiology catheter and method of use for mapping and ablation procedures. The catheter includes a braided conductive member at its distal end that can be radially expanded. The catheter can be used in endocardial and epicardial mapping and ablation procedures.

Claims

AMENDED CLAIMS[received by the International Bureau on 07 January 2002 (07.01.02); original claims 1-13 replaced by new claims 1-83 (10 pages)]
1. A medical device for electrophysiology procedures, comprising: a catheter having a braided conductive member at a distal end thereof; a mechanism that expands the braided conductive member from an undeployed to a deployed position; and a shroud that covers at least a portion of the braided conductive member when the braided conductive member is in the deployed position.
2. The medical device of claim 1 , wherein the shroud is a latex material.
3. The medical device of claim 1 , wherein the shroud is composed of an radiofrequency transparent material.
4. The medical device of claim 1, wherein the shroud is comprised of a material resistant to thrombi formation.
5. The medical device of claim 1 , wherein the shroud directs irrigation fluid to a target region.
6. The medical device of claim 1 , wherein the shroud directs contrast fluid to a target region.
7. The medical device of claim 1 , wherein the shroud directs antithrombogenic fluid to a target region.
8. The medical device of claim 5, wherein the target region is a circumferential edge of the braided conductive member.
9. The medical device of claim 6, wherein the target region is a circumferential edge of the braided conductive member. 27
10. The medical device of claim 1 , wherein the shroud covers the entire braided conductive member.
11. The medical device of claim 1 , fαirther comprising a hollow tubular lumen within the catheter.
12. A medical device for electrophysiology procedures, comprising: a catheter having a braided conductive member at a distal end thereof; a mechanism that expands the braided conductive member from an undeployed to a deployed position; and a mechanism that steers the distal end of the catheter.
13. The medical device of claim 12, wherein the mechanism that steers the distal end of the catheter includes a pivot point proximal to the braided conductive member.
14. The medical device of claim 13, wherein the mechanism that steers the distal end of the catheter includes a pivot point distal to the braided conductive member.
15. The medical device of claim 14, wherein the catheter has a first curve in a first plane and a second curve in a second plane at an angle to the first plane.
16. The medical device of claim 12, wherein the braided conductive member is a wire mesh.
17. The medical device of claim 12, further comprising at least one reference electrode disposed on a shaft of the catheter.
18. The medical device of claim 16, wherein the wire mesh includes a number of filaments. 28
19. The medical device of claim 18, wherein the mechanism that expands the braided conductive member expands one or more individual filaments in the wire mesh.
20. The medical device of claim 12, wherein the braided conductive member includes multiple braided conductive members.
21. The medical device of claim 20, wherein the braided conductive members have different expanded diameters.
22. The medical device of claim 20, wherein at least one of the braided conductive members is used for mapping procedures.
23. The medical device of claim 20, wherein at least one of the braided conductive members is used for ablation procedures.
24. The medical device of claim 16, wherein the wire mesh is symmetrical and coaxial about a shaft of the catheter.
25. The medical device of claim 16, wherein the wire mesh is non concentric about a shaft of the catheter.
26. The medical device of claim 16, wherein the wire mesh is asymmetric about a shaft of the catheter.
27. The medical device of claim 16, wherein the wire mesh is preformed to approximate a portion of anatomy.
28. The medical device of claim 12, wherein the braided conductive member comprises a single filament. 29
29. The medical device of claim 18, wherein the filaments have a round cross section.
30. The medical device of claim 18, wherein the filaments have a rectangular cross section.
31. The medical device of claim 18, wherein the filaments includes metallic and non metallic elements.
32. The medical device of claim 18, wherein the filaments are isolated by an insulation coating.
33. The medical device of claim 18, wherein the insulation coating is a polyimide type material.
34. The medical device of claim 18, wherein a portion of the insulation coating is removed from at least one of the filaments.
35. The medical device of claim 34, wherein the insulation coating is removed from the filaments to create at least one sector.
36. The medical device of claim 12, further comprising a hollow tubular lumen within the catheter.
37. A medical device for electrophysiology procedures, comprising: a catheter having a braided conductive member at a distal end thereof; a mechanism that expands the braided conductive member from an undeployed to a deployed position; and a coating material disposed on at least a portion of the braided conductive member. 30
38. The medical device of claim 37, wherein the coating is a lubricious coating.
39. The medical device of claim 37, wherein the coating is an antithrombogenic coating.
40. The medical device of claim 37, wherein the coating is a radioopaque coating.
41. The medical device of claim 37. wherein the coating material is a thermally conductive coating.
42. The medical device of claim 37, further comprising a hollow tubular lumen within the catheter.
43. A medical device for electrophysiology procedures, comprising: a catheter having a braided conductive member at a distal end thereof; a mechanism that expands the braided conductive member from an undeployed to a deployed position; and an irrigation system that delivers an irrigation fluid in proximity to the braided conductive member.
44. The medical device of claim 43, wherein the irrigation system includes at least one tube woven into the braided conductive member.
45. The medical device of claim 44, wherein the at least one tube includes at least one opening for delivering the irrigation fluid.
46. The medical device of claim 43, wherein the irrigation fluid is a contrast fluid. 31
47. The medical device of claim 43, wherein the irrigation fluid is a cooling fluid.
48. The medical device of claim 43, wherein the irrigation fluid is an antithrombogenic fluid.
49. The medical device of claim 43, wherein the braided conductive member includes a number of filaments and at least one of the filaments includes a lumen that delivers the irrigation fluid.
50. A medical device for electrophysiology procedures, comprising: a catheter having a braided conductive member at a distal end thereof; a mechanism that expands the braided conductive member from an undeployed to a deployed position; and a temperature sensing device attached to the braided conductive member.
51. The medical device of claim 50, wherein the temperature sensing device comprises a thermocouple.
52. The medical device of claim 50, further comprising a hollow tubular lumen within the catheter.
53. A guiding mechanism for use with an electrophysiology catheter, comprising: a sheath having a predetermined curve through which the electrophysiology catheter may be passed during introduction to a patient; and a seam disposed along a longitudinal length of the sheath.
54. The guiding mechanism of claim 53, wherein the guiding sheath further includes a hypo tube having a lumen that communicates with an interior of the sheath. 32
55. A method for treating cardiac arrhythmia, comprising the steps of: introducing a catheter into a thoracic cavity of a patient, the catheter having a braided conductive member at a distal end thereof; contacting an exterior wall of a blood vessel or cardiac chamber with the braided conductive member; and applying energy to the exterior wall via the braided conductive member to create a lesion on the exterior wall.
56. The method of claim 55, wherein the braided conductive member is a wire mesh.
57. The method of claim 56, further comprising the step of directing irrigation fluid to a target region.
58. The method of claim 56, further comprising the step of directing contrast fluid to a target region.
59. The method of claim 56, further comprising the step of directing antithrombogenic fluid to a target region.
60. The method of claim 56, further comprising the step of steering the distal end of the catheter.
61. The method of claim 56, further comprising the step of measuring temperature when applying energy to the blood vessel.
62. The method of claim 55, further comprising the step of coating the braided conductive member with a coating material. 33
63. The method of claim 62, wherein the coating step includes using a lubricious coating.
64. The method of claim 62, wherein the coating step includes using an antithrombogenic coating.
65. The method of claim 62, wherein the coating step includes using a radioopaque coating.
66. The method of claim 62, wherein the coating step includes using a thermally conductive coating.
67. The method of claim 62, wherein the coating step includes using an insulation coating.
68. The guiding mechanism of claim 54, wherein the lumen allows introduction of an irrigation fluid.
69. The guiding mechanism of claim 54, wherein the lumen allows introduction of a contrast fluid.
70. The guiding mechanism of claim 54, wherein the lumen allows introduction of an antithrombogenic fluid.
71. The medical device of claim 1, wherein the shroud directs an antithrombogenic fluid to a target region.
72. The medical device of claim 43, wherein the irrigation fluid is an antithrombogenic fluid. 34
73. The medical device of claim 51 , wherein the thermocouple is electrically insulated from the braided conductive member.
74. A medical device for electrophysiology procedures, comprising: a catheter having a braided conductive member at a distal end thereof; a mechanism that expands the braided conductive member from an undeployed to a deployed position; wherein the braided conductive member is constructed of thermocouples.
75. A medical device for electrophysiology procedures, comprising: a braided conductive member having a first end and a second end; a first catheter shaft having an extreme distal end wherein the first end of the braided conductive member is attached to the extreme distal end of the catheter shaft; a second catheter shaft hiving an extreme distal end wherein he second end of the braided conductive member is attached to the extreme distal end of the second catheter shaft and wherein the second catheter shaft is contained within the first catheter shaft; so that in an undeployed position, the braided conductive member is substantially contained within the first catheter shaft; and when the extreme distal end of the first catheter shaft is substantially aligned with the extreme distal end of the second catheter shaft, the braided conductive member is in a deployed position.
76. The medical device of claim 75, wherein the braided conductive member is a wire mesh.
77. The medical device of claim 76, wherein the wire mesh includes a number of filaments.
78. The medical device of claim 77, further comprising a coating material disposed on at least a portion of the wire mesh. 35
79. The medical device of claim 77, further comprising an irrigation system that delivers an irrigation fluid in proximity to the braided conductive member.
80. The medical device of claim 77, further comprising a temperature sensing device attached to the braided conductive member.
81. The medical device of claim 77, further comprising a shroud that covers at least a portion of the braided conductive member when the braided conductive member is in the deployed position.
82. The medical device of claim 75, wherein the braided conductive member further comprises a concentric locating region when the braided conductive member is in the deployed position.
83. The medical device of claim 75, further comprising a hollow tubular lumen within the catheter.
PCT/US2001/013840 2000-05-03 2001-04-27 Apparatus and methods for mapping and ablation in electrophysiology procedures WO2001082814B1 (en)

Priority Applications (8)

Application Number Priority Date Filing Date Title
US20144500 true 2000-05-03 2000-05-03
US20448200 true 2000-05-16 2000-05-16
US20445700 true 2000-05-16 2000-05-16
US26101501 true 2001-01-11 2001-01-11
US60/201,445 2001-01-11
US60/204,457 2001-01-11
US60/204,482 2001-01-11
US60/261,015 2001-01-11

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE2001638880 DE60138880D1 (en) 2000-05-03 2001-04-27 Apparatus for multi-dimensional representation and ablation in electrophysiology procedures
JP2001579692A JP4926359B2 (en) 2000-05-03 2001-04-27 Apparatus and method for performing mapping and ablation in electrophysiology procedures
EP20010934942 EP1284670B1 (en) 2000-05-03 2001-04-27 Apparatus for mapping and ablation in electrophysiology procedures

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WO2001082814A2 true WO2001082814A2 (en) 2001-11-08
WO2001082814A3 true WO2001082814A3 (en) 2002-04-04
WO2001082814B1 true true WO2001082814B1 (en) 2002-05-02

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JP (1) JP4926359B2 (en)
DE (2) DE60138880D1 (en)
EP (3) EP1642544B1 (en)
WO (1) WO2001082814B1 (en)

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US6837886B2 (en) 2005-01-04 grant
US20050065420A1 (en) 2005-03-24 application
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US9028486B2 (en) 2015-05-12 grant

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